12.1 Drugs used in Psychiatric Disease

Question 1

What are the core symptoms of depression?

Answer 1

Low mood
Anhedonia
Low energy
(2/3 needed)

Question 2

What are some secondary symptoms of depresion?

Answer 2

Decreased appetite
Sleep disturbance
Hopelessness
Self harm/suicidal thoughts
Decreased libido

Question 3

What is the monoamine hypothesis of depression?

Answer 3

Depression is due to lack of noradrenaline and serotonin

Question 4

What is the receptor hypothesis of depression?

Answer 4

Abnormality in receptors for monoamine transmission

Question 5

What are the 3 hypotheses for depression pathophysiology?

Answer 5

Monoamine
Receptor
Gene expression

Question 6

What are some anti depressant drugs?

Answer 6

Imipramine
Lofepramine
Citalopram
Fluoxetine
Sertraline
Venlafaxine
Amitryptilline

Question 7

Which antidepressants are SSRIs?

Answer 7

Fluoxetine
Citalopram
Sertraline

Question 8

How do SSRIs work?

Answer 8

They inhibit the reuptake of serotonin

Question 9

What are some ADRs of SSRIs?

Answer 9

Anorexia
Nausea
Diarrhoea
Precipitation of mania
Prolonged QT

Question 10

Which antidepressants are TCAs?

Answer 10

Amitriptilline
Imipramine
Lofepramine

Question 11

How do TCAs work?

Answer 11

Inhibits NA reuptake
Muscarinic blockade
Alpha 1 blockade

Question 12

What are ADRs of TCAs?

Answer 12

CNS sedation
Autonomic block - decreased glandular secretions
Tachy cardia, postural hypotension, decreased contractility
Constipation

Question 13

Which antidepressants are SNRIs (Serotonin, Noradrenaline reuptake inhibits)?

Answer 13

Venlafaxane

Question 14

What are some ADRs of SNRIs?

Answer 14

(Same as SSRI) Anorexia, nausea, diarrhoea

+ sleep disturbance, hypertension, dry mouth

Question 15

What are some positive symptoms of schizophrenia?

Answer 15

Hallucinations
Dellusions
Thought disorders
Abnormal behaviour

Question 16

What are some negative symptoms of schizophrenia?

Answer 16

Blunted effect

Social withdrawal

Question 17

What are some cognitive symptoms of schizophrenia?

Answer 17

Selective attention
Poor memory
Reduced abstract thought

Question 18

What are some possible causes of schizophrenia?

Answer 18

Dopamine too high?
Serotonin too high?
Decreased glutamate function?

Question 19

What are some typical schizophrenia drugs?

Answer 19

Haloperidol

Chlorapromazine

Question 20

What are some atypical schizophrenia drugs?

Answer 20

Olanzapine
Risperidone
Quetiapine
Clozapine

Question 21

What are some side effects of typical antischizophrenia drugs?

Answer 21

Extrapyramidal - Parkinsonism, tardive dyskinesia, acute dystonia
Neuroleptic malignant syndrome
Postural hypotension
Weight gain
CNS depression
Cardiotoxicity

Question 22

What are some side effects of atypical antischizoprenia drugs?

Answer 22

Weight gain
Hyperprolactinaemia
Extrapyramidal side effects if high dose

Question 23

What is anxiety?

Answer 23

Fear out of proportion to situation?

Question 24

What is used to manage anxiety?

Answer 24

CBT

Drugs - antidepressants, anxiolytics, sometimes antipsychotics

Question 25

What are some anxiolytics that can be used to anxiety treatment?

Answer 25

Diazepam | Lorazepam

Question 26

How do the benzodiazepine anxiolytics work?

Answer 26

Enhancing GABA and therefore inhibitory action on the brain

Question 27

What do you need to be careful about with benzodiazepines?

Answer 27

Don't give too long a dose - tolderance and dependence can occur quickly

Question 28

What ADRs can occur with benzodiazepines?

Answer 28

``` Drowsiness Dizziness Psychomotor impairment Dry mouth Decreased BP ```

Question 29

Benzodiazpines can be teratogenic, what problems can they cause in pregnancy?

Answer 29

Cleft lip and palate | Resp depression in late pregnancy

Question 30

What are some mood stabilisers in biploar disorder?

Answer 30

Lithium | Valproic acid

Question 31

What are some ADRs with lithium?

Answer 31

``` Nephrotoxic Memory problems Thirst Polyuria Tremor Hypothyroidism ```

Question 32

What can be used to treat dementia?

Answer 32

AChesterase inhibitors - donepezil, galantamine | NMDA antagonist - mamantine

Question 33

What are ADRs of ACh inibitors?

Answer 33

Nauesea, vomiting, anorexia, diarrhoea Fatigue insomnia Bradycardia Peptic ulcers

Question 34

What are some ADRs of memantine?

Answer 34

Hypertension Dyspnoea Dizziness Drowsiness